Saturday, January 29, 2005

Here's a wake up call to all anesthetists who have yet to discover the world of PDAs. Waking Up Costs blogs about Palm Anesthesiology a useful resource written by Donald M. Voltz M.D. for Anesthetists who use Palm PDAs.
We need more Expert Guides in other medical disciplines..... Palmsource better wake up too...

Friday, January 28, 2005

A survey conducted by MedAmerica Mutual Risk Retention Group Inc. found that its physicians were able to avoid a range of medical errors by using PDAs. The Walnut Creek, Calif.-based liability payer surveyed 224 of its insured physicians for the study, conducted throughout 2003 and 2004.
Sixty-five percent of survey respondents said they avoided dosing errors by using PDAs. Another 58% said they avoided dosing frequency errors. Further, 25% said they avoided a drug error; 24% a therapeutic error; and 18% avoided other errors.
MedAmerica Mutual conducted the survey to assess the impact of its support of PDA use in clinical care. In 2001, the payer began offering its physicians PDAs and subsidies to purchase drug reference software from Epocrates Inc., San Mateo, Calif.

It seems that this sort of data is dependent on the respondents' feedback. A prospective study may give more reliable data but short of this, surveys do give some idea how physicians are using their PDAs and how useful they find them.
It's good to hear that Payers see the value in offering PDAs and drug reference subsidies. Now if only more of them do so (especially where I work!).

USBMIS is announcing the beta version of Bookstein’s Medical Student’s PDA Reference, for Palm and Pocket PC devices. If you would like to be part of the free beta test group for this application, you can download the beta version at BooksteinBooks.com.Beta testing will continue until Febuary 15, 2005.

More info:

Bookstein’s Medical Student’s PDA Reference is designed for all medical students, interns, and other trainees and physicians working on clinical services. It provides a streamlined well-organized source of clinically relevant medical information for your handheld device. The content includes concise discussions of 3000 diseases within all body systems. The application is a complete quick reference covering all areas of medicine, so you will never be without the answer.
The PDA edition features interlinked content, a comprehensive index, useful tables, classification systems, and databases.
Author Ken Bookstein, MD, of Portland, Oregon, has written four editions of this popular reference work. But it is now available for PDA for the first time!

Among the other features of Bookstein’s Medical Student’s PDA Reference are:
1. Consistency in organization: each disease is presented in a logical fashion, with epidemiology, diagnostic information, radiologic and pathologic information, and approaches to treatment.
2. Nonspecific clinical presentations with focus on diagnostic workup and differential diagnoses.
3. Indications, classification, adverse reactions and mechanisms for approximately 700 pharmacologic agents.
4. Information on cytokines, hormones, autocoids, neurotransmitters, toxicology, vitamins, and nutrition.
5. Outlines of vascular anatomy and muscular insertion points.

Thursday, January 27, 2005

Skyscape has released WUCEndo™ (The Washington Manual® Endocrinology Subspecialty Consult)

Prepared primarily by residents, fellows, and attending physicians, this handy guide is ideal for residents called on to do an inpatient consult, for students working on an inpatient medicine service, and for specialists seeking information on endocrinology and general internal medicine management. This PDA reference covers inpatient and outpatient approaches, symptoms and diseases, and acute and chronic problems with the same front-lines practicality as the world-famous Washington Manual® of Medical Therapeutics.
Entries cover hypothalamic and pituitary disorders, thyroid disorders, adrenal disorders, gonadal disorders, disorders of bone and mineral metabolism, and disorders of fuel metabolism, including diabetes mellitus type 1 and type 2, hypoglycemia, and hyperlipidemia. Coverage of endocrine neoplasms includes MEN syndromes and carcinoid syndrome.

Wednesday, January 26, 2005

I last blogged about RSS feeds and Plucker back in July last year.
I still use Plucker (latest version being 1.8) as my preferred offline browser and RSS reader. Up till recently though, I have been using Jpluck to grab web pages and RSS/XML feeds and convert them into Plucker format. The author of Jpluck has stopped development and has since moved on to Sunrise. I decided to tag along and I must say Sunrise is a great improvement over Jpluck. You can schedule downloads for individual feeds and the best part is Sunrise will not convert the page if it has not changed - something Jpluck is not smart enough to do. This has encouraged me to grab even more pages and feeds:

Hmmm. Maybe I've gone a little overboard here ;)
Seriously though, this Sunrise/Plucker combo is great stuff and if you have not tried it I suggest you do. PPC users are not left out too since there is Vade Mecum which is a Plucker reader for PPC.
Doctors suffer from the N.E.T. (not enough time) syndrome and what better way to optomise your time than to take your favorite web pages and RSS feeds with you to read on your Palm while queueing up in the hospital the staff canteen.

I spotted Medgadget's SIMPill posting which is about a "pill bottle that uses cellphone technology to remind patients to take their medicines and warns them if they are about to take an extra dose by mistake. " Apparently an SMS is sent to a central server once the pill bottle is opened and if there is any delay, then the server will notify the patient or healthcare professional, aslo via SMS. Cool, but perhaps a little hi-tech you say? When it comes to important illnesses like TB where DOTS is the way to go, using technology like this would automate things.
I think there might be a market for more hi-tech pill bottles. Someone might comeup with a Bluetooth enabled pill bottle or pill dispenser - so if you open the pill bottle or container, it automatically contacts your bluetooth enabled PDA or phone and transmits a record to it that indicates the medication has been taken. That way patients or healthcare professionals can track the patient's compliance. The author of On-Time-Rx could well incorporate this Bluetooth technology to interface with the hi-tech pill bottles.

One of the first e-medical references I purchased (for US$90+) was a pocket version of Harrison's some years ago when Ram was precious and I was using a Palm Pilot Pro with a TRG expansion card. If you think about it, that's pricey by today's standards. To be honest I didn't find it very useful in the end. Storage in handhelds is now much bigger and space is no longer that much of a constraint. I think full versions would be more useful. To my mind what is important is interface: the reference should be easily searchable and accessible otherwise it won't be used much either.
Just my 2 cents.

Friday, January 21, 2005

A fellow KVPUGer, peterscm, has completed the stand-alone conversion of the Asian Food Calorie database.
Now with a PalmOS (sorry no PPC version!) PDA, you can carry with you and calculate how much calories, cholesterol, Na+, fibre etc you've ingested after pigging out on that Asian meal. I think this is a useful resource since there are precious few databases on Asian food nutrional values.

Here are some screenshots:

The splashscreen:

Food items are selected either from the drop down list or by keying in the name of the food at the bottom and the program will jump to the food item:

For each item, you can input several amounts of each item (translation: say you pigged out and ate 20 sticks of satay instead of 4):

You can view the damage for each item:

And here's the best part, peterscm has included a Total function and you can export all of these values to Palm's Memo:

Where to get this program? It's not yet released so stay tuned. If you are interested, please leave a comment here or email me.

Saturday, January 15, 2005

Lexi-comp has improved on their software and has introduced a new feature which makes updates easier for users.
MobileHeathData reports:

Lexi-Connect software now enables users to click on an icon on their desktop PC that brings them to the vendor's software update Web site and searches for new data.
The new information then is automatically downloaded to the PC and to all Windows Mobile-based PDAs the PC supports. PDAs that run the Palm OS operating system must be synched to receive the data after it's downloaded to the PC.
Prior to this update enhancement, users had to manually install each of the vendor's clinical reference databases individually to ensure they had the most up-to-date information. The new update enhancement also enables users to link back to the Lexi-Comp home page to automatically renew their licenses for the vendor's reference systems.

The Webinar includes TWO chances to win:
- a free Treo 650 smartphone from palmOne, OR
- a customized Needs Assessment from PatientKeeper

The blurb:

How are healthcare organizations and providers taking advantage of the latest advances in mobile technology and preparing for the future? This webinar explores extending existing IT investments, driving adoption among physicians, and avoiding future obsolescence. PatientKeeper will review key advancements and market trends. Physicians from CHRISTUS Health (Corpus Christi, TX) and MedStar Health (Baltimore, MD) will share their personal experiences with selecting and deploying mobile healthcare solutions.
You will learn how the packaged patient management solution from PatientKeeper, palmOne, and Cingular Wireless can help you access and update clinical information as you travel from your office to one or more hospitals -- across multiple hospital information systems -- on the largest digital voice and data network in America, with the power and versatility of one of today?s most popular smartphones, the new Treo 650.

Tuesday, January 11, 2005

Ferri's Clinical Advisor 2005 provides the busy physician with a fast, efficient way to identify important clinical information about the most commonly encountered medical disorders. The PDA edition includes all diseases and disorders (615 common medical conditions), the complete differential diagnosis text (displays nearly every possible cause for 472 different signs and symptoms), a large selection of laboratory tests, Periodic Health Exam tables, and herbal product appendices—all in the palm of your hand.

The American Cancer Society C-Tools Webpage has been revamped and they are on-target for release of the Palm and PPC versions of C-Tools by the end of the month, the beta testing phase having just been completed.

Monday, January 10, 2005

AMNews has an interesting article dated January 17th (wow, a sneek preview!!) on Doctors and handhelds.

When handheld devices hit the market, many experts predicted that physicians, even those who weren't early adopters of computers and health technology, would quickly find use for a device that seemed to fit right into their busy lives, their need to have access to information and their constant mobility.
And those predictions were correct. About 40% of practicing physicians owned a personal digital assistant in 2004, up from 19% in 2001 and more than four times greater than the overall percentage rate of consumer adoption, said Mark Bard, president of Manhattan Research LLC, a market research company in New York.
But the other end of those predictions hasn't held up -- that physicians would find PDAs useful as a clinical tool. Although physician adoption of PDAs in the past four years soared for various reasons, the devices have yet to come close to being used for their fullest potential in medicine.

I agree. How many colleagues do you know who are under using their PDAs or PDAphones? I know of some who use it only for the contacts and addresbook book function. I have seen plenty of empty Memos and Todos and nary a Medical application. Only yesterday I showed a diabetologist colleague who got pretty interested when I demo'd Statcoder's great freebies like Cholesterol™ (can you ™ Cholesterol btw ;) ). It's just about lack of awareness I think.
Someone in the Chatterbox just asked about a list of "must have" Medical applications for the Palm. I guess this list will vary a little from doctor to doctor so could you guys care to submit to me your favorites and I'll compile them here.

In the meantime the same article has some interesting stats:

Over the past four years, the percentage of practicing physicians who have and use personal digital assistants has grown significantly, though it appeared to have stalled in 2004.

Adoption rate
2001 19%
2002 30%
2003 40%
2004 40%

Source: Manhattan Research LLC

And suggests some areas for you to "tap" your underused PDA:

Although many doctors use a personal digital assistant, most physicians are using PDAs for personal rather than professional use. Here are some of the applications or tasks that a PDA can help you perform in the office:

Love the new launcher. It supports shortcuts to applications, files (like MP3s), folders and even web links.
It makes navigation fast and easy.
Here's a screenshot:

The other thing I love about the T5 is the contsant 320x480 mode, and in fact I didn't realise Medcalc supported it nicely too! :)

Besides this, I do lova the much improved battery life and overall the T5 feels almost as sprightly as the T3. Downside is application and data size becomes really bloated and some functions like soft reset are MUCH slower. Overall I could live with this PDA and would recommend it to colleagues - especially forgetful ones who seem to keep losing data when they go on holidays and forget to charge their Palms!

Well am having a busy weekend so far trying to port over my T3 applications to my new T5. I am pleased to report that the key medical applications like Medcalc, Skyscape applications, Lexi-drugs work on the T5. Pity Skyscape apps still can't make us of the full 320x480 screen real estate.
I also run medical databases using HanDbase and find that Handbase 3.0k is OK but there were occasional crashes on exit if I save the databases on SD card.
Yes and Haemoncrules works fine ;)

Wednesday, January 05, 2005

Sigh. Had to "upgrade" from my T3 to the T5 as my T3 is again exhibiting digitizer madness and I cannot tap on the items on the status bar at the bottom when the T3 is in extended mode. While not critical, it is annoying.
So I decided to take the plunge and get myself a T5 after reviews do reveal that on the whole it's not that bad ;) I guess I could live without a voice recorder and vibrating alarms (don't use the latter anyway) and the trade off would be the sliderless big screen and better battery. I was also pleased that palmOne came out with the Wifi drivers for the SD card which I already own.
So now I am testing out software and seeing what I need to update or even chuck out if there is incompatibility.
Right now, I am checking out this great thread in 1src forums and this T5 compatibility list being maintained by Lance Wehrung. The software listed include medical ones so its worth checking these out.

Tuesday, January 04, 2005

I am a second year medical student from Canada. Before medical school, I graduated from pharmacy where I first was exposed to a palm IIIXE. The minute I saw epocrates and how easy it was to look up drugs, I knew I needed to get one. Since that I have had the Palm IIIXE, then a Sony PEG415 (high-res B&W), then Tungsten T (great device but all buttons froze so it was warrantied), then Tungsten T3 (amazing device) w/ 256Mb SD.
I do not use epocrates anymore. There are far better resources out there. For a drug resource, I rely almost entirely on Lexi-drugs and the other Lexi-comp programs.

I use these programs most often:
1. Isilo- great for all the texts you can find on the net; also very useful for capturing web pages with isiloX
2. Lexi-comp package- Lexi-drugs (Canadian drug names and easiest to find answer quickly), interact (best interaction program out there), 5MCC (great for med school and likely afterwards to get a quick briefing on a particular disease)
3. Stedman’s Medical dictionary- most thorough dictionary and very useful for a medical student
4. Eponyms- great for looking up all the disease’s named after egotistical doctors :) and best of all it is free
5. MedCalc- great program with great interface
6. Docs to go- great program especially when used with the Palm Ultrathin keyboard.
7. Others- many skyscape programs, Sanford guide, etc.
8. Utilities- Filez, backupman, YAUC, SC-103PU scientific calculator

I am still waiting for T3 LEAP driver for the palm wifi card so I can use it at the university.

Thanks for for feedback Robert. A Gmail invite goes out to you - there are still three left for anyone else who wishes to contribute.
I think Lexi-comp has a more comprehensive drug information database compared with ePocrates and importantly too, it supports memory card storage.
As for the Leap driver there is one for the Tungsten C so hopefully someone will come out with one for the SD Wifi card.

Sunday, January 02, 2005

My introduction to PDA’s came relatively late. My first PDA was the Palm Tungsten T2 with a 128 MB sd card which I bought in the famous Low Yatt Plaza in 2003. Trusty machine. I am now a senior house officer at a hospital in Christchurch, New Zealand. I work an equal mix of adult general medicine and adult general surgery.

Calculators: Medcalc. Journalclub(for all those statistics and terms related
to epidemiology. Extremely useful for our monthly journal club)
Organizer: Agendus Standard Edition
Drug references: Epocrates Rx ver 7, MIMS (provided free to all hospital
doctors , and by far the best for Australia/NZ specific drugs) BNF
September 2004 (Isilo--x version)
Textbooks: Harrison’s Principles of Internal Medicine
Current Medical Diagnosis and Treatment 2003
Current Surgical Diagnosis and Treatment 2003
Clinical Guides: Our health board provides its own in-house manual for
resident doctors. It is called ‘the blue book’(isilo) informally. Contains
guidelines for various emergencies, various protocols for medications and
useful contact numbers applicable to within that health department. Please
don’t ask me for a copy because its copyrighted.
There is also a ‘pink book’(in isilo) for us. It’s an antibiotic guideline
which is updated according to the sensitivity patterns of the local microbes
in Christchurch area. Tells you the most appropriate antibiotic to use for a
particular condition. Very useful when treating things like community
acquired pneumonia, immunodeficiency associated infections etc.
Notes: Hi-note. And also starring my most recent acquisition, my IR wireless
keyboard.
Fun and Games: Vexed. ( I swear, I’ve never heard of some of those Beatles
songs!!)
Other fun: Various e-books. I use isilo format mostly, with Repligo
occasionally when I get books in pdf. Repligo beats Adobe Reader, hands
down. There’s a huge selection of free books (by out of copyright authors)
from The Gutenberg Project Online. I’m reading Dostoyevsky’s Crime and
Punishment in isilo format at the moment.
Keeping up to date: I mainly read New England Journal of Medicine on my
computer at home. If there’s an article I want to read some more, I save it
as PDF and use Repligo to send it to my PDA. I use Highwire to get the BMJ
onto my pda, but I end up reading the BMJ on the PC anyway , because
Highwire doesn’t include all the interesting bits, like the funny anecdotes.
Miscallaneous: Documents to Go Premium for keeping my presentations. FileZ
for file management. Froggysoft’s Necktie for learning how to tie a necktie.
Music: None.
Video clips: None.
Bluetooth: Don’t use it much , I’m afraid. GPRS is still expensive in New
Zealand, and I don’t own a Bluetooth enabled phone ….yet. Bluechat is just
stupid, but fun. Until your battery runs out.
My hopes: Please let Palmone make a pda with wifi inbuilt! And please let
there be a hospital Wifi network with electronic prescribing, electronic
patient tracking, electronic investigation requests, and high speed internet
for all the impoverished house-officers!!

Hey there Ming! You're the first KVPUGer to share his/her Palm Medical experience. PalmOne does have a PDA with Wifi built-in and it's the Tungsten C which is getting really long in the tooth. I would have gotten the Tungsten C if not for it's lack of Bluetooth which is essential for wireless communications with my Phone. Well, I guess GPRS is not that cheap over here too but with "all-you-can-eat" Edge/GPRS internet access packages being rolled out now, it is getting to be quite interesting.
Yes, I too would find the ability to access the hospital LIS even just to look up lab results wirelessly via PDA a great boon to productivity.
A Gmail invite goes to Ming for sharing his thoughts and experiences all the way from the Antipodes. 4 Gmail invitations left folks!

Saturday, January 01, 2005

Another day, another year. I wonder what 2005 has in store for us in terms of PDAs and Medicine? I look forward to the survival of palmOne and Palmsource and hope that a new Palm PDA model (the elusive dual wireless one) emerges sometime this Spring.
Wishing all of you a Happy and Blessed 2005!